In an article published earlier this week I described how Federal government had decided to move your local healthcare provider a little farther toward Hellth by forcing him or her to buy an electronic health record (EHR) by 2014. Any doctors who are reckless or ignorant enough to refuse will be punished by having their Medicare reimbursement cut by 1% each year. If, for example, Dr. Perfect refuses to buy and “meaningfully use” an EHR by 2019, she will receive 5% less from Medicare for providing exactly the same services (or even better, higher quality services), as Dr. Bumbler, her EHR-using colleague.
In my previous post I had likened this to forcing our already cash-strapped healthcare system to buying a “pig in a poke”. The only thing that we know for certain about the affect of this law is that it will require enormous expenditures of time and money on the part of healthcare providers and the taxpayers. The standard justifications for buying these systems and forcing doctors to use them vary a bit, but are always some combination of “cost savings”, “improving quality”, revulsion over the idea that anything remains uncomputerized, and “keeping up with the Joneses”. This pronouncement made by President Obama last year is typical:
“This will cut waste, eliminate red tape, and reduce the need to repeat expensive medical tests,” said Obama. “It just won’t save billions of dollars and thousands of jobs — it will save lives by reducing the deadly but preventable medical errors that pervade our health care system,” he added.
As is this one from President Bush upon launching his own EHR initiative in 2004:
“In calling for the widespread adoption of EHRs, Bush said, ‘[t]he 21st-century healthcare system is using a 19th-century paperwork system.’ He said paper records contain too many errors and inefficiencies, and they hinder communication between healthcare providers.”
Well as luck would have it, the annual meeting of the Health Information Management Systems Society (HIMSS) was held this week,. As you may or may not know, HIMSS is the trade organization for EHR vendors, and its members will be the chief beneficiaries of federal tax dollars and mandates directed toward EHR deployment. Many of the leading EHR poke-meisters were there. One of them was Dr. Jon White, director of the Health IT Portfolio at the Agency for Healthcare Research and Quality at HHS. According to Healthcare Business News, here’s what he had to say:
“White told the attendees that AHRQ is funding a number of IT-related projects through grants and contracts. Though everyone from the president to patients considers the widespread adoption and use of IT as the cure for what ails the healthcare system, White acknowledged that “there’s not great evidence that IT saves money.” He also said IT vendors get a “bad rap” for developing and selling IT systems that may not necessarily improve patient care. “IT vendors work hard and frequently build what their customers ask for,” White said, placing at least part of the blame for ineffective IT systems on hospitals and physicians themselves.
White described the relationship between AHRQ and the Office of the National Coordinator for Health Information Technology, which are both under HHS, as a “sibling rivalry” when it comes to promoting the role of IT in healthcare. He said the two agencies have put aside that rivalry to partner on the new AHRQ National Resource Center for Health IT, which will provide needed research and guidance on IT implementation and its use to improve patient care.
“I’m on my third national coordinator,” White said, describing all of them as “nice people” who all are committed to the healthcare IT cause.”
There is lots to to be said for nice people. And it’s quite a relief to know that IT vendors aren’t the ones responsible for selling IT systems that don’t improve patient care or save any money. But as the President’s healthcare IT chief assured HIMSS vendors:
“I’m optimistic,” Blumenthal said. “I think the wind is at our back in so, so many ways.”
I’m glad he’s optimistic. But then again, I suppose his job depends on his saying so, doesn’t it?